History Of Dental İmplants

History Of Dental İmplants

Dental implants are not a modern miracle that appeared overnight. They are the result of centuries of trial, error, failure and progress. Understanding how they developed helps us appreciate why today’s implants work so well, and why certain rules and protocols in implant dentistry are so important.

Ancient attempts to replace missing teeth

Humans have always cared about chewing and appearance. Archaeological findings from Egypt, the Etruscans and the Mayans show that people tried to replace missing teeth thousands of years ago.

In some skulls, researchers found shells, carved bones, stones or animal teeth placed where natural teeth had been. Most of these were probably done for ritual or aesthetic reasons, often after death. There was no concept of sterile surgery, no real understanding of bone healing, and certainly no osseointegration.

Even though these “implants” were not functional the way we think today, they show something important: the desire for a complete smile and better function is as old as civilisation itself.

From tooth pullers to real dentistry

For a long time, teeth were handled by barbers and “tooth-drawers”, not by specialised doctors. Things started to change in the 18th and 19th centuries. Dentistry slowly became a recognised profession, supported by science rather than just experience.

Three major changes prepared the ground for modern implants:

• Pain control – The discovery of nitrous oxide, ether, chloroform and later local anaesthetics meant patients could tolerate longer and more delicate procedures.

• Radiography – With X-rays, dentists could finally see roots and bone, not just what was visible in the mouth.

• Better restorative materials – Porcelain, metal alloys and later acrylics allowed more natural-looking artificial teeth.

At this point, dental implants still did not work predictably, but the tools were forming: better diagnosis, safer surgery, and the idea that dentistry could restore not just comfort, but also function and aesthetics.

Early modern metal implants (1700–1900)

Between the late 1700s and early 1900s, some brave clinicians tried to place metal structures directly into the jawbone to support crowns. They experimented with gold, platinum, silver and other metals.

The idea was clear: create an artificial root inside the bone. The problems were also clear:

• Infection was common because sterilisation was poor or non-existent.

• Bone did not properly join to these implants.

• Many implants became loose, painful or infected, and had to be removed.

However, these early attempts taught the profession important lessons:

• Material choice matters – not all metals are tolerated well by the body.

• The implant must be in close contact with bone, not just “lying in a hole”.

• The implant must be able to share chewing forces with the bone, not just sit passively.

These ideas would become central later, when better materials and techniques arrived.

New designs, mixed results (1900–1980)

The 20th century brought a wave of creativity in implant design. Many types were introduced, such as:

• Basket implants – hollow designs meant to let bone grow through.

• Spiral or screw-shaped implants – inspired by orthopaedic screws.

• Blade implants – thin, flat pieces placed into a slit in the bone.

• Subperiosteal implants – metal frameworks sitting on top of bone but under the gum, especially for very resorbed jaws.

Some patients did quite well with these systems and used them for years. But overall, the results were unpredictable. Often, a layer of fibrous tissue formed between the implant and bone. This meant mobility, inflammation and eventual failure.

Even though many of these designs are no longer used, this period was not a waste. It helped refine:

• Surgical techniques – flap design, closure, asepsis.

• Impression and prosthetic methods – how to connect implants to prostheses.

• Thinking about load distribution – how forces travel through bone and implants.

The profession just needed one key breakthrough: a truly biocompatible material that could bond directly with bone.

Brånemark and osseointegration: the real turning point

That breakthrough came with Per-Ingvar Brånemark, a Swedish researcher. While studying blood flow and bone healing, he noticed that bone bonded tightly to titanium in such a way that the metal could not be removed without breaking the bone.

From this observation, he developed a full dental implant system based on commercially pure titanium. The innovation was not just the metal, but the biological concept he defined:

• Osseointegration is a direct, stable connection between living bone and an implant surface, without soft tissue in between.

Brånemark’s team standardised:

• Implant design

• Surface characteristics

• Surgical protocols

• Healing times and loading concepts

Long-term clinical studies showed high survival rates compared with previous designs. Presentations in the late 1970s and early 1980s convinced many dentists that endosseous titanium implants were no longer experimental, but a predictable treatment option.

From rare procedure to routine option

After the acceptance of osseointegration, implant dentistry entered a new era. Industry and clinicians worked together to create:

• Different diameters and lengths for various bone situations

• Different surfaces to speed up and strengthen bone integration

• Connections and abutments that improved stability and prosthetic options

At the same time, techniques like bone grafting, sinus lifting and guided bone regeneration made it possible to treat patients with less bone.

Imaging also advanced:

• Digital radiography improved detail and reduced radiation.

• CT and CBCT allowed true 3D evaluation of bone and surrounding structures.

• Computer-guided surgery helped place implants with more precision and safety.

Implants moved from being used only by a few specialists to becoming part of everyday treatment planning in many practices. Patients began to see implants as a standard solution when a tooth was missing.

Why this history is still important

Knowing the history of dental implants is not just a curiosity. It affects how we practise today. This story reminds us that:

• Every design choice – length, diameter, connection type, surface – is based on lessons from past successes and failures.

• Biology always wins. Mechanical ideas alone are not enough; the body must accept and integrate the implant.

• Long-term follow-up is crucial. Many “new” ideas look good in the short term but must prove themselves over many years.

• Innovation is valuable, but patient safety and evidence must guide decisions.

Today, when a dentist places an implant, it might look like a simple, routine procedure to the patient. In reality, it is the result of centuries of human effort to restore missing teeth in a way that is functional, comfortable and natural-looking.

From ancient shells to titanium roots guided by 3D imaging, the journey of dental implants shows how science, technology and human need can come together to transform lives.